Final Medicare Payment Regulations Expected for Physician Providers, Hospitals and Home Health Agencies in Fall 2017

September 5, 2017

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The Centers for Medicare & Medicaid Services (CMS) released several annual Medicare proposed payment rules over the summer that are expected to be finalized this fall for 2018.

On July 13, CMS released the proposed 2018 Physician Fee Schedule that would update payment policies, payment rates and quality provisions for physicians and other medical professionals under the Medicare program. The proposed payment update would be 0.31 percent for 2018. The CMS factsheet on the proposed payment rule is available here. Comments are due September 11, 2017.

On July 13, CMS released the proposed 2018 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System that would provide for the 2018 rates and quality provisions. The proposed payment update would be 1.75 percent for 2018. The CMS factsheet on the proposed rule is available here. Comments are due September 11, 2017.

On July 25, CMS released the proposed 2018 Home Health Prospective Payment System that would update payment rates for home health agencies. The proposed payment update would reduce overall Medicare payments to home agencies by 0.4 percent for 2018, saving an estimated $80 million. The CMS factsheet on the home health proposed payment rule is available here. Comments are due September 25, 2017.

Takeaway: The proposed Medicare payment regulations reflect a broader strategy that CMS is pursuing to "relieve regulatory burdens for providers; support the patient-doctor relationship in health care; and promote transparency, flexibility and innovation in the delivery of care." Stakeholders are expected to weigh in on the proposed rules, and it is uncertain which proposals will make it into the final payment regulations, expected to be released in November 2017.

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